摘要
目的:回顾性探讨、研究主动脉炎的临床与病理学特点,提高对此类疾病的认识,避免漏诊、误诊。方法:从武汉亚心总医院2016年1月1日至2021年12月31日共1838例升主动脉病理资料中筛选出活动性主动脉炎24例。收集临床资料包括病史、影像学数据、实验室检查、免疫抑制剂、激素治疗及随访情况。病理学资料包括主动脉瓣和主动脉的大体所见、病理组织分型及组织学改变。连续变量以±s来描述,频数分布用百分比来描述。结果:在这24例活动性主动脉炎中,术前临床确诊为动脉炎1例,怀疑动脉炎7例,其余16例在病理检查中发现。由病理检查发现的16例主动脉炎的出院诊断为血管型白塞综合征1例,感染性主动脉炎2例,多发性大动脉炎3例,临床孤立性主动脉炎10例。所有患者均无主动脉瓣狭窄,21例患者伴有主动脉瓣关闭不全。11例主动脉炎的标本出现中膜块状凝固性坏死。本研究共有5例血管型白塞综合征,其中3例伴有主动脉瓣的急性非感染性心内膜炎。结论:本研究中大部分的主动脉炎是在病理检查中意外发现的,每种主动脉炎都有被漏诊的病例,其中临床孤立性主动脉炎全部漏诊。大部分主动脉炎发生在单纯性主动脉瓣关闭不全的患者中。中膜块状凝固性坏死是诊断主动脉炎的一个重要线索。急性非感染性心内膜炎是诊断血管型白塞综合征的一个重要线索。
Objective To explore the clinicaland pathological characteristics of aortitisin order to improve the understanding of this rare conditionand improve correct diagnostic rate.Methods Twenty-four cases of active aortitis were identified from a total of 1838 cases of ascending aorta specimens in the last 6 years at Wuhan Asia General Hospital.Clinical data including medical history,laboratory and imaging data were collected and the treatment with immunosuppressive and hormonal treatment as well as follow-up data were analyzed.Pathological data including gross findings,microscopic features of the aortic valve and aorta were analyzed.Continuous variables were expressed as mean±standard deviation.Frequencies were described as percentages.Results Among the 24 cases of active aortitis,1 case was clinically diagnosed as aortitis before operation,7 cases were suspected aortitis before operation,and the other 16 cases were diagnosed as aortitis after pathological examination.Among those 16 cases,one case was Behcet′s syndrome,2 cases were infectious aortitis,3 cases were Takayasu aortitis,and 10 cases were clinically isolated aortitis.None case had aortic stenosis,while 21 cases had aortic valve insufficiency.Eleven cases of aortitis showed coagulation necrosis.In the 5 cases of Behcet′s syndrome,3 had acute noninfectious endocarditis of aortic valve.Conclusions Most of the aortitis in this study was found accidentally in pathological examination.All of the clinically isolated aortitiswere misdiagnosed before pathological examination.Most of the patients with aortitis had simple aortic valve insufficiency.Coagulation necrosis is an important clue for the diagnosis of aortitis.Acute noninfectious endocarditis is an important clue for the diagnosis of Behcet′s syndrome.
作者
瞿维
陈佑平
张真路
Qu Wei;Chen Youping;Zhang Zhenlu(Department of Pathology,Wuhan Asia General Hospital,Hubei 430022,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2023年第4期230-235,I0002,共7页
Chinese Journal of Rheumatology
关键词
主动脉炎
病理检查
组织学分型
Aortitis
Pathological examination
Histologic classification
